Coping with a Picky Eater
By William G. Wilkoff, M.D.
Do you often prepare two or three different menus for supper because your child continues to reject each of your offerings? Have you gotten tired of dumping full plates of food down the garbage disposal? Do you feed him canned spaghetti every evening because you know he will eat it?
Do mealtimes often end in arguments between you and your spouse over how much and what your child should be eating? Does your child often complain of bellyaches during meals? Have you resorted to bribery with stickers, treats, or toys just so your picky eater will eat some of his vegetables? Has your mother taken you aside and told you that she is worried because her grandson looks skinny and never cleans his plate?
If your child is between the ages of one and five years and doesn't eat as much as you think he should or seems to avoid the variety of foods that you think is healthy, you have in your hands a book that will help you understand and cope with this behavior. If meals have become times of tension and squabbling, I can show you how to create a dinner table atmosphere that will allow every family member to enjoy sitting down together again. Even if your child is only nine months old and you are beginning to wonder if he will ever broaden his range of favorite foods, you will find this book helpful, because you will find it also contains suggestions for prevention as well as management of picky eating.
Setting the Stage
You may be parents who are both employed out of the home and are working with a day care provider who is feeding your child one or two meals per day. You may be a single parent and find yourself facing your child's picky eating alone, or you may share custody and must deal with eating behavior in situations over which you have little control. If you are adoptive parents, particularly if your child has come from a foreign country, you may be unsure how to respond to your child's food preferences and how to interpret his growth patterns. This book will help.
Picky eating is a behavior that almost every small child will exhibit some time before he turns six, and it is one of the most common topics of discussion at well-child visits in my pediatric office. Your child's failure to eat as heartily as you think he should is probably high on your list of parental worries.
In most cases picky eating will begin around age one. It begins to wane as the child gets into a school situation and starts to fall under the influence of peers and other role models he will find away from home, usually when he is three to five years old. For some children this is a lifelong pattern that will be evident even when they are in college. There are many children who will eat well most of the time and then, often inexplicably, will become very choosy for a few weeks or months. The advice in this book can be useful for all of these children from the occasional picky eater to the one whose eating habits are legendary in the family and around the neighborhood.
Coping with a Picky Eater is an appropriate resource for you even if you think that your child's eating behavior is normal, but your spouse, your mother, your in-laws, or your day care provider thinks that your child is a pick)' eater. You may find out that their perception is correct, or you may learn enough in these pages to be able to understand that your child's eating pattern is normal.
This book is not for the parents of a child with a chronic disease, severe emotional problems, or one whose diet must be significantly restricted by allergy or by physical limitations that make chewing or swallowing difficult. I have also excluded children from age nine to eighteen years because preadolescents and adolescents can have complex and often serious eating disorders that demand more than just effective parenting skills. These young people usually need a combination of medical management and psychotherapy, which is clearly beyond the scope of this book.
What you will learn as you read through these pages is that picky eating is a very common behavior among small children. You will learn how to determine if your child's eating habits fit into the range of this normal pattern, and you will learn if your style of parenting is contributing to the behavior. You will discover that there are several simple changes you can make in the way you present food to your child that help you avoid some of the nutritional pitfalls that picky eaters can fall into, and I will show you how you can create a family meal that is no longer an ordeal to be endured, but is instead an event that the entire family will eagerly anticipate and enjoy.
While this book is short enough to be read in a sitting or two, you will probably find that you will come back to it several times as your child grows and his eating patterns change and present new challenges. Since picky eating is a behavior that may persist for many months or even years, you will want to come back to some of the chapters again and again for booster shots of emotional strength as you work to bolster your coping skills. You will discover that Coping with a Picky Eater will become an important part of your parenting survival kit, a member of your support group that you can hold in your hand.
Why Coping and Not Curing?
As soon as I decided to write a book for parents of picky eaters, I knew exactly what the title would be. For twenty-five years I had been working with families struggling with children who didn't eat the variety and quantity of food their parents thought they should. I learned quickly that these children were not going to give up their finicky ways because of anything that I was going to do. I didn't have any magic potion stashed away in my black bag that was going to make these stubborn little birds finish, or even start, eating their peas.
One doesn't cure something that is normal, and picky eating is normal behavior for children in the one- to five-year age group. However, in many families this "normal" behavior creates considerable havoc. Parents worry, concerned that their child is ill or that she is going to become ill because she isn't eating properly. Parents argue with each other about what to serve and how to punish or reward what they consider acceptable behavior. Meals are no longer fun for anyone in a family with a picky eater. Some children react by complaining of belly pain at the dinner table and a few even vomit because of the pressure to eat that they must endure.
Most parents feel responsible for their child's well-being and so feel obligated to get her to eat what they feel is a "balanced" diet in sufficient quantity every day. The problem occurs when there is a discrepancy between the parents' perceptions of what constitutes a healthy diet and the reality of what their child actually eats each day. Fearful that their child will become ill or stop growing, they panic and try a variety of desperate measures to get their picky eater to eat.
Often parents prepare three or four meals per sitting to get their picky cater to ingest something and to satisfy the wishes of other finicky family members. It is not uncommon for each person at the table to have a completely different selection of food on his plate, because the child may not be the only picky cater in the family. For example, Dad may be having steak, eight-year-old Martha is getting chicken because she and her friends have given up red meat, and Mom is just having a green salad because she is trying to lose weight. Four-year-old Robbie is being offered frozen pizza because everyone "knows" that he won't eat what the rest of the family is eating.
Other parents give their child a monotonous and unhealthy diet because that is what he will eat. In my practice macaroni and cheese and corn are particular favorites, and I know of many children who are served this "Nothing green, please" entree five nights out of seven because they won't try anything else. I can recall one family that sheepishly admitted they had been offering their child a bowl of breakfast cereal every night for dinner for the three months before they came to see me. What begins as a "normal childhood behavior" often spirals into a chaotic and very abnormal family situation. The parent responsible for preparing the meal is asked to function well beyond the call of duty. Meals often degenerate into arguments as parents attempt to force the child into eating. Parents begin to yell at each other as they try to assign blame for their picky eater's frustrating behavior. The child may begin to complain that she doesn't feel well because that is the only way she knows how to stop the carnage.
Some parents are fortunate enough to be able to accept their child's picky ways without much concern and find something else to worry about, but they are in the minority. Most parents need some reassurance and coaching on how to cope with their child's finickiness. Sometimes I can be of help merely by examining the picky eater and reminding her parents how well she is looking and growing. However, I often find that I need to help parents set limits on their own and their child's behavior. I don't cure the child of her picky eating. I teach the parents coping skills. Maybe the child becomes a little less picky, but, more important, the atmosphere in the family improves and meals again become times to be enjoyed and not dreaded.
I was introduced recently to a woman who had been told that I was writing a book about picky eating. She said, "Our pediatrician just told me to offer our boys what I thought they should have and then not worry. They did just fine." Obviously, she didn't need to read my book. I would put her comment in the same category with Nancy Reagan's response to drugs: "Just say no!" It's the correct answer, but it is too simplistic for situations most of us face.